Abstract:Precision Medicine Initiation and "Healthy China 2030" Plan have created a good opportunity for development of biobank. However, it also faces many challenges in the process of building up Chinese biobank, including different standards for biobank, electronic information system and clinical treatment, incomplete laws and regulations, and the obstacles of sustainable development. Unremitting efforts are needed to guide, Chinese biobank development on the right track of standardization, informatization and normalization.

Abstract:Recently, improved comprehension of renal cell carcinoma (RCC) pathogenesis has led to the development of small molecule targeted-drug, receptor tyrosine kinase (RTK) inhibitors such as sunitinib and sorafenib, which are now the mainstay of therapeutic options for advanced RCC patients. However, 15% of advanced RCC patients are inherently refractory to targeted-drug, and most of the remaining patients end up with drug resistance and tumor progression after 6-15 months of therapy with sunitinib, resulting in the failure to efficiently prolong the survival of RCC patients. Therefore, it is urgent to explore the potential mechanisms of targeted-drug resistance and to identify the biological markers to predict efficacy of targeted-drug in RCC. Recently, we found that long non-coding RNA (lncRNA) plays a key role in target-drug resistance of RCC, which had been published in Cancer Cell, Nature Communications and Oncogene. In this comment, we systematically reviewed our research results in targeted-drug resistance of RCC. Besides, we also share our views on future directions in targeted-drug resistance, hoping to provide implications for future study.

Abstract:Objective To explore the mutation frequency of single nucleotide polymorphism (SNP) in the breast cancer susceptibility gene (BRCA)1/2 coding region and its relationship with clinicopathological features of Chinese patients with hereditarily high-risk breast cancer. Methods We extracted the DNA of peripheral blood mononuclear cells from 69 Chinese hereditarily high-risk patients with breast cancer, and detected the sequences of 49 exons in BRCA1/2 coding region by second-generation sequencing technology. At the same time, we collected the clinicopathological data of all patients, including the age at diagnosis, the age at menarche, first pregnancy age, TNM stage, immunohistochemical status, whether it was bilateral breast cancer and/or with family history, and analyzed the relationship of site polymorphism of BRCA1/2 coding region with clinicopathological features of breast cancer. Results A total of 34 SNPs were identified, among which 14 were located in the BRCA1 and 20 in the BRCA2 coding region, including 18 high frequency sites and 16 low frequency sites. The rs80356892 site polymorphism of BRCA1 coding region was significantly correlated with the clinicopathological features of breast cancer. The patients with rs80356892 site mutation were inclined to have bilateral breast cancer (P=0.005), family history (P=0.029) and triple negative breast cancer (P<0.001). In addition, SNP in rs80356892 site was negatively correlated with the expressions of estrogen receptor and progesterone receptor. Conclusion SNP in BRCA1/2 coding region are associated with the onset risk and the clinicopathological features of breast cancer. The detection of SNP may contribute to risk assessment of breast cancer and screening and prevention of hereditary breast cancer.

Abstract:Objective To explore the effect of supine or prone position on central venous pressure (CVP) and intra-abdominal pressure (IAP) during lumbar spine surgery when using Jackson operating table or normal operating table. Methods This study included 36 patients undergoing lumbar spine surgery in Changhai Hospital of Second Military Medical University between Sep. and Dec. 2014, with 18 patients in the Jackson operating table (Jackson group) and 18 patients in the normal operating table (Normal group). We recorded and analyzed the CVP, IAP, mean arterial pressure (MAP) and heart rate (HR) of the patients in two groups in the supine position after anaesthesia induction, prone position after anaesthesia induction for 10 min, prone position before the end of surgery and supine position at the end of surgery. Oxygenation index (OI) was recorded after anaesthesia induction in the supine position and prone position for 10 min, 30 min and 60 min. Linear regression analysis was used to analyze the correlation between IAP and CVP when in different positions. Results Compared with supine position, the IAP values in two groups were significantly decreased in the prone position for 10 min (P<0.01), CVP value in Jackson group was significantly decreased (P<0.01) and that in Normal group was significantly increased (P<0.01); MAP and HR in Normal group were significantly decreased (P<0.05) and OI in Jackson group was significantly increased (P<0.01), while MAP and HR of the patients in Jackson group and OI in Normal group were not significantly different from the supine position. There was a positive correlation between IAP and CVP in the prone position in the Jackson group (r=0.709 3, P<0.01),but not in the Normal group (P>0.05). In the Jackson and Normal groups, the results of linear regression analysis showed positive correlations between CVP in the supine position and CVP in the prone position (r=0.760 7, 0.829 7; P<0.01), and between IAP in the supine position and IAP in the prone position (r=0.752 8, 0.920 0; P<0.01). Conclusion The effect of prone position on circulation is less in the Jackson group and it can improve oxygenation when the surgery is in the prone position. IAP may be used as a supplementary monitoring index of rehydration rate and fluid volume.

Abstract:Objective To prepare a polycaprolactone (PCL) composite scaffold which can slowly release bone morphogenetic protein 2 (BMP-2) for a long time, and to explore the application value of PCL composite scaffold in bone tissue engineering through studying osteogenic differentiation level of human bone mesenchymal stem cells (BMSCs). Methods The BMP-2/PL compounds (B/P), formed by the BMP-2 and soybean phospholipid (PL), were dispersed in methylene dichloride, and then we mixed it with PCL and prepared the PCL-B/P composite scaffold and PCL-B traditional scaffold loaded with BMP-2 by phase separation method. The slow-release of BMP-2 from two kinds of scaffolds was observed with ELISA assay. The human BMSCs were cultured in the media containing PCL-B/P composite scaffold or PCL-B traditional scaffold, and the proliferation abilities and osteogenic differentiation levels of BMSCs on two kinds of scaffolds were detected and analyzed by CCK-8 assay and qPCR, respectively. Results Compared with the PCL-B traditional scaffold, PCL-B/P composite scaffold in this study showed a better slow-release effect of BMP-2 and a longer slow-release time of 22 days. The proliferation abilities of BMSCs on PCL-B/P composite scaffold were better than that on PCL-B traditional scaffold on the 7^th day, 14^th day and 21^st day of cell culture (P<0.05). The alkaline phosphatase content and mRNA expressions of collagen type Ⅰ, osteocalcin and osteopontin of BMSCs in the PCL-B/P composite scaffolds were significantly higher than those in the PCL-B traditional scaffold (P<0.05, P<0.01). Conclusion We have successfully prepared a PCL-B/P composite scaffold loaded with BMP-2. The PCL-B/P composite scaffold can slowly release BMP-2 for a long time and induce the proliferation and osteogenic differentiation of human BMSCs.

Abstract:Objective To explore the effects of prescription optimization of 5-fluorouracil (5-FU) patch and electrostatic field of the negative polarity electret on the in vitro release behavior of 5-FU from the 5-FU patch. Methods The corona charging technology at ambient temperature was applied for preparation of －1 000 V and －2 000 V negative polarity electrets. The negative polarity electret 5-FU patch was prepared by using Eudragit E100 as pressure-sensitive adhesive (PSA), tributyl citrate as plasticizer, and water-soluble azone as chemical permeation enhancer. We used the single factor method to investigate the influences of PSA, plasticizer, water-soluble azone and negative polarity electret on the relevant parameters of the 5-FU patch. The optimal prescription was screened by orthogonal design test. We also studied the influence of negative polarity electret on the in vitro release behavior of 5-FU from the 5-FU patch by using modified Franz diffusion cell and high-performance liquid chromatography. Results (1) The optimal prescription was fitting when the mass of Eudragit E100 was 0.25 g, the mass ratio of plasticizer to Eudragit E100 was 55:100 and the mass fraction of water-soluble azone was 3%. (2) Both the －1 000 V and －2 000 V negative polarity electrets used in this study promoted the in vitro release of 5-FU from the 5-FU patch; and the promoting effect was proportional to the surface potential of the electret. (3) Compared with the single use of 3% water-soluble azone, negative polarity electret combined with 3% water-soluble azone significantly increased the in vitro release of 5-FU from the 5-FU patch (P<0.05). Conclusion Negative polarity electret and water-soluble azone can reduce the holding capacity of the 5-FU patch and promote the in vitro release of 5-FU from the 5-FU patch, and the promoting effect is more significant in the combination of them.

Abstract:Objective To prepare hyaluronic acid-graft-poly (ethylene glycol)/α-cyclodextrin hollow nanocapsules loaded with asparaginase (AHAPs) and to investigate their in vitro stability and activity. Methods We prepared the AHAPs by self-assembly method and detected the optimal temperature, optimal pH value, particle size, zeta potential and entrapment efficiency. Then the differences in in vitro stability between AHAPs and free asparaginase (AN) were investigated by measuring thermal stability, acid- and basic-stability, stability to trypsinase, stability to metal ions and organic compounds, plasma stability and storage stability. The interaction between AN and blank hyaluronic acid-graft-poly (ethylene glycol)/α-cyclodextrin hollow nanocapsules was studied through the fluorescence experiment. Results The optimal temperature for AHAPs was 50 ℃, the optimal pH value was 7.0, the mean particle size was (424.53±7.25) nm, and the mean zeta potential was (－48.77±0.99) mV. The entrapment efficiency of AHAPs was (64.40±1.82)%. The results of stability experiment showed that AHAPs had a significantly better in vitro stability than free AN, and some stability experimental results were statistically significant (P<0.05). Fluorescence experiment showed that the improvement of biological activity of AHAPs may be related to the change of protein residues microenvironment and enzyme conformation caused by the interaction between AN and blank hyaluronic acid-graft-poly (ethylene glycol)/α-cyclodextrin hollow nanocapsules. Conclusion It has been found that AHAPs can not only improve the activity but also greatly enhance the stability of AN in vitro.

Abstract:Objective To explore the clinical characteristics of acute kidney injury (AKI) by different causes and to evaluate the patients' outcomes. Methods We searched for the renal function indicators of all the inpatients of Changzheng Hospital in 2011 by the hospital information management system, screened AKI patients according to KDIGO criteria, reviewed the medical histories of AKI patients and divided them into pre-renal, intrinsic-renal and post-renal AKI according to different causes, and then we analyzed the clinical features of the AKI patients and evaluated their outcomes. Results A total of 278 AKI patients were involved in this study and the overall incidence of AKI was 0.896%. The cases with pre-renal, intrinsic-renal and post-renal AKI were 200(71.9%), 63(22.7%) and 15(5.4%), respectively. Significant differences were found among the three groups concerning age, basic serum creatinine (sCr) and peak sCr (P<0.05). The detection rates had a significant difference among three groups (P<0.05), with that of intrinsic-renal AKI patients being the highest (28.6%, 18/63). Among the three groups, the renal replacement therapy rate was the highest in the intrinsic-renal group (17.5%, 11/63). The pre-renal AKI occurred most frequently in liver transplantation department, the intrinsic-renal AKI was frequently found in nephrology department, and the post-renal AKI was in neurosurgery department. Logistic regression analysis showed that the AKI stage was a risk factor for death and renal function prognosis in the pre-renal AKI patients, and age and AKI stage were the risk factors for renal function recovery in the patients with the intrinsic-renal AKI. Conclusion The incidence of pre-renal AKI is the highest, and it occurs frequently in liver transplantation department. AKI stage is the risk factor for the prognosis of the patients with pre-renal AKI. The basic sCr and peak sCr are higher in the intrinsic-renal AKI than in pre- and post-renal AKI. The intrinsic-renal AKI occurs frequently in nephrology department and it can be easily caused by drugs. Age and AKI stage are the risk factors for renal function recovery in the pre-renal AKI patients. The outcome of post-renal patients is the best.

Abstract:Objective To explore the effect of transcription factor E-twenty-six variant gene 5 (ETV5) on the phenotypic switching of vascular smooth muscle cells (VSMCs). Methods The VSMCs were transfected with adenovirus vector overexpressing ETV5 in Ad-ETV5 group and green fluorescent protein (GFP) in Ad-GFP group. The VSMCs were transfected with human ETV5-specific small interfering RNA (siRNA) in platelet-derived growth factor (PDGF)-BB+siRNA_ETV5 group and siRNA with random negative sequence in PDGF-BB+siRNA_scramble group before inducing with PDGF-BB. The qPCR and Western blotting analysis were used to detect mRNA and protein levels of phenotypic switching markers of VSMC, including α-smooth muscle actin (α-SMA) and myosin heavy chain 11 (MYH11). Scratch wound assay and CCK-8 assay were performed to identify the proliferation and migration of VSMCs. Results Compared with the Ad-GFP group, the expressions of mRNA and protein of α-SMA and MYH11 were significantly decreased in the Ad-ETV5 group (P<0.05), while the abilities of proliferation and migration were significantly improved (P<0.05). Compared with PDGF-BB+siRNA_scramble group, the expressions of mRNA and protein of α-SMA and MYH11 were significantly increased in the PDGF-BB+siRNA_ETV5 group (P<0.05), while the abilities of proliferation and migration were significantly inhibited (P<0.05). Conclusion ETV5 may play an important role in the phenotypic switching of VSMCs.

Abstract:Objective To explore the effect of forkhead box O1 (FOXO1) gene on the expression and transcription of vascular endothelial growth factor-A (VEGF-A) through overexpressing or silencing the FOXO1 gene in vitro. Methods The human immortalized gingival keratinocyte (HIGK) was cultured and transfected with ON-TARGET plus SMART pool for human FOXO1 siRNA or ON-TARGET plus Non-targeting Control Pool (control siRNA), the fluorescence intensity of VEGF-A was measured by the immunofluorescence staining in vitro. Luciferase assay was used to test the VEGF-A luciferase activity by FOXO1 overexpression or FOXO1 silence. Results The VEGF-A protein levels in HIGK transfected with FOXO1 siRNA significantly reduced by 57% compared with HIGK without transfection (P<0.05). The luciferase reporter results showed that overexpression of FOXO1 resulted in a 2.1-fold increase in VEGF-A transcriptional activity (P<0.05), and FOXO1 silencing produced a 20%-43% decrease in VEGF-A transcriptional activity (P<0.05). Conclusion FOXO1 in HIGKs can regulate VEGF-A protein expression.

Abstract:Objective To explore the role of adenosine A1 receptor (A1R) in pathogenesis of gestational hypertension and preeclampsia. Methods Placenta tissues derived from puerperae with gestational hypertension (n=6), preeclampsia (n=14) and from normal control placentae (n=15) were obtained. The expression location of A1R protein in placenta tissues was detected by immunofluorescence technique, and the expression quantity of A1R protein was performed by Western blotting analysis. We created the normal, hypoxia (8, 24, 48 and 72 h) and hypoxia-reoxygenation trophoblastic cell models, and detected the A1R mRNA and protein expressions in trophoblastic cell models by real-time quantification PCR and Western blotting analysis. Transwell assay was used to determine the invasion ability of trophoblastic cells treated with the A1R antagonist, 8-cyclopentyl-1,3-dipropylxanthine (DPCPX), and Western blotting analysis was used to detect the expression of protein kinase A (PKA) protein. Results We observed that A1R protein was expressed in both trophoblastic cells and vascular endothelial cells. A1R expression was significantly higher in mild and severe preeclampsia placenta tissues than that in normal placenta tissues (P<0.01). A1R expression in the hypoxia model of trophoblast cells significantly was increased with the prolongation of hypoxia (P<0.05). The invasion ability and PKA expression in the hypoxia model of trophoblast cells were significantly lower than those in normal placenta tissues (P<0.01, P<0.05). DPCPX significantly increased the invasion ability of trophoblastic cells and the PKA expression (P<0.05). Conclusion The prolongation of hypoxia can increase the expression of A1R in the trophoblast cells, which may be related to regulated PKA expression.

Abstract:Objective To explore the efficacy and safety of 70% ethanol lock for the prevention of catheter related blood stream infection (CRBSI) in maintenance hemodialysis (HD) patients with a tunnel cuffed central venous catheter. Methods A randomized self-crossover controled method was used in this study. A total of 32 HD patients with tunnel cuffed catheters, from the Department of Nephrology of Zhongda Hospital of Southeast University, were randomly assigned to ethanol lock group (the patients received 3.3 mL 70% ethanol lock once a week and 3.3 mL standard heparin lock twice a week) and heparin lock group (the patients received 3.3 mL standard heparin lock three times a week), each group with 16 patients, and the lock methods of two groups were exchanged after locking for 22 weeks. We then analyzed and compared the incidences of CRBSI, catheter dysfunction and another adverse reactions of the patients in two groups. Results Two patients withdrew from the study, two died, and totally 28 patients fully participated in the study, with each group haviny 14 patients. The incidence of CRBSI was 0.45 per 1 000 catheter-days in ethanol lock group and was 0.92 per 1 000 catheter-days in heparin lock group, showing significant difference between the two groups (P> 0.05). There was no significant difference in the incidence of catheter dysfunction between the ethanol lock group and the heparin lock group (0.90 per 1 000 catheter-days vs 2.06 per 1 000 catheter-days; P> 0.05). There were no significant differences in routine blood test, liver function or coagulation function between the two groups. The patients in the ethanol lock group were not observed with adverse reactions, including nausea, vomiting or dizziness. Conclusion The incidence of CRBSI has been declining in the maintenance HD patients with a tunnel cuffed catheter in the ethanol lock group, although it is not significantly different from the heparin lock group.

Abstract:Objective To analyze the postoperative complications and prognosis of the patients undergoing cranioplasty at different stages after decompressive craniectomy, and to explore the optimal timing of cranioplasty after decompressive craniectomy for skull defect. Methods We retrospectively analyzed the clinical data of 83 patients who underwent cranioplasty from Nov. 2012 to Nov. 2015. According to the different timing of cranioplasty after decompressive craniectomy, the patients were divided into the early-stage group (≤3 months, n=31) and the late-stage group (>3 months, n=52). We recorded and compared the incidence of postoperative complications in the two groups. The Glasgow outcome score (GOS) and Karnofsky performance status (KPS) score were used to evaluate the prognosis of the patients in the two groups. Results The incidence of hydrocephalus in the early-stage group (16.13%, 5/31) was significantly higher than that in the late-stage group (1.92%, 1/52; P<0.05), while the incidence of other postoperative complications was not significantly different. And the GOS score and KPS score of the early-stage group were significantly higher than those of the late-stage group (GOS score: 4.16±0.86 vs 3.63±0.72, P<0.05; KPS score: 80.32±16.22 vs 70.19±16.27, P<0.05). Conclusion Early cranioplasty after decompressive craniectomy can improve the neurological function and prognosis of the patients with traumatic brain injury, but it may increase the incidence of hydrocephalus.

Abstract:Objective To explore the effect and the regulatory mechanism of miRNA-142-3p (miR-142-3p) in rat alveolar macrophage inflammatory response stimulated with lipopolysaccharide (LPS). Methods The rat alveolar macrophages NR8383 were stimulated with 100 ng/mL LPS, and the mRNA and protein expressions of miR-142-3p and high-mobility group box 1 (HMGB1) were determined by qPCR and Western blotting analysis after stimulating for 0, 6, 24 and 48 h. We then transfected the macrophage with miR-142-3p mimic in vitro and used qPCR to measure the mRNA expressions of miR-142-3p, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1β and macrophage inflammatory protein 2β (MIP-2β). Western blotting analysis was used to measure the protein expression of HMGB1, and ELISA was used to observe the concentration of HMGB1 in cell culture fluid. Results The highest expression of miR-142-3p was found in NR8383 cells when stimulated with LPS for 48 h and the highest concentration of HMGB1 was noticed at 24 h stimulation, and they were significantly different from those at 0 h (P<0.05). After overexpression of miR-142-3p, the expression of miR-142-3p was significantly increased (P<0.05), and the expressions of HMGB1 protein and mRNA of HMGB1, TNF-α, IL-6, IL-1β and MIP-2β were significantly decreased (P<0.05). Conclusion miR-142-3p can mediate the NR8383 cell inflammatory response induced by LPS, which may be caused by negative regulation of HMGB1 expression.

Abstract:Objective To explore the effect of cannabinoid 1 receptor (CB1R) overexpression on the neurological function of mice with experimental autoimmune encephalomyelitis (EAE) and the related mechanism. Methods Twenty-four C57B/L6 mice were selected to prepare EAE models by MOG_35-55 immunization and were divided into two groups. CB1R was overexpressed in mouse spinal cord tissue by plasmid transfection technique in CB1R overexpression group, and the other group was given solvent as control. The neurological deficits of mice were observed in control group and CB1R overexpression group. The expression of CB1R in the spinal cord of mice were detected by Western blotting analysis. The concentrations of interleukin (IL)-10, IL-17, IL-6, and tumor necrosis factor-α (TNF-α) were measured by ELISA. Results The degree of neurological deficit of mice in the CB1R overexpression group was significantly lower than that in the control group on 14^th and 28^th day after immunization (P <0.05). Compared with the control group, the expression of CB1R protein in spinal cord in the CB1R overexpressing group was significantly increased (P <0.01), the concentration of IL-10 was significantly increased (P <0.05), and the concentrations of IL-17, IL-6, and TNF-α were significantly decreased (P <0.05, P <0.01). Conclusion CB1R overexpression in central nervous cells can postpone the development and progression of EAE in mice, which may be achieved through immuomodulation.

Abstract:Aquaporin-2 (AQP2) water channels in principal cells of the kidney collecting duct are essential for water reabsorption and the balance of water metabolism of the body. AQP2 is abundant in the apical plasma membrane and intracellular vesicles of collecting duct principal cells. Arginine vasopressin (AVP) can stimulate the translocation of AQP2 from intracellular vesicles into the plasma membrane, which is the so-called short-term regulation or traffic of AQP2. Several molecular mechanisms underlying the traffic of AQP2 have been identified, including phosphorylation of AQP2, a kinase anchoring protein, phosphodiesterase (PDE), cytoskeleton participation, calcium participation, anchoring and endocytosis cell membrane. This review introduced the recent research advances in the mechanisms of the traffic of AQP2.

Abstract:Atrial fibrillation (AF) is one of the most common types of arrhythmia in clinical practice. AF is prone to be permanent or even permanent AF from paroxysmal AF, which was called AF self-stabilization. Atrial electrical remodeling (AER) is a typical change of atrial electrophysiology in the AF self-stabilization process. Small conductance Ca²⁺-activated K⁺ channel (SK channel) is recently found and widely distributed in cardiac myocytes, and it is highly sensitive to Ca²⁺. Researches have shown that SK channels may affect AF self-stabilization through influencing the process of AER directly. This review aimed at summarizing the mechanisms of SK channels in the AF self-stabilization progress and the related intervention measures and discussing the role of SK channels in clinical practice.

Abstract:Block copolymer micelle has attracted great attention as an effective drug delivery system. It has many merits, such as increasing the solubility of hydrophobic drug, prolonging the in vivo drug circulation time, improving drug stability and enhancing the therapeutic effect of anticancer agents. Micelle morphology plays an important role in its drug loading, in vivo distribution and pharmacokinetic behavior. Here in this paper we provided a review of the critical factors affecting the morphology of block copolymer micelles (polymer, preparation factors, drug and others) for future reference.

Abstract:Capsular warning syndrome (CWS) is a specific form of transient ischemic attack with low incidence; however, it may proceed to acute cerebral infarction with high possibility. In this review, we summarized the pathogenesis and mechanisms, clinical symptoms, imaging features, treatment and prognosis of the CWS, hoping to attract the clinicians' attention on it and to promote the early diagnosis of patients with CWS, and thus to improve the prognosis of CWS.

Abstract:Based on the concept and function of geographic information system (GIS) and medical geographic information system (MGIS), we preliminarily designed the framework of MGIS for 21^st Century Maritime Silk Road and evaluated the role of MGIS in rescuing ships and people on the sea, epidemic prevention, health supplies and medical evacuation of the wounded. We also pointed out the existing problems and the solutions.

Abstract:Objective To explore the allocation scheme of the navy forward surgical team (NFST) and to obtain the related technical and tactic indicators on the sea. Methods We borrowed the theory and experience of foreign forward surgical team and conducted service consultation through Brainstorm method and Delphi method; we created the conceptual model of NFST, including three allocation schemes. The professional simulation software ProModel was used to simulate and modify these schemes. Results The first scheme (Scheme 1) was used for one surgical bed, 6 medical staffs and 2 post-surgical beds, with the daily number of surgical patients being 10. The second scheme (Scheme 2) was used for two surgical beds, 10 medical staffs and 4 post-surgical beds, with the daily number of surgical patients being 21. The third scheme (Scheme 3) was used for three surgical beds, 15 medical staffs and 6 post-surgical beds, with the daily number of surgical patients being 31. Conclusion The proposal, simulation and optimization of three allocation scheme in this study can help the decision-making in the establishment of NFST.

Abstract:Objective To explore the clinical efficacy of lienal polypeptide injection combined with transcatheter arterial chemoembolization (TACE) for treatment of patients with advanced primary liver cancer. Methods A total of 60 patients with advanced primary liver cancer were enrolled from Jun. 2013 to Jan. 2015 in Eastern Hepatobiliary Surgery Hospital, and were divided randomly into treatment group (lienal polypeptide injection combined with TACE, n=30) and control group (TACE, n=30). We observed the quality of life (KPS score) and immunity index of the patients in two groups before treatment and observed the clinical efficacy (RECIST 1.1 criteria), KPS score and immunity index after treatment for one month, then and recorded and compared the adverse effects and survival rates in two groups. Results The objective effective rate (complete remission and partial remission) was 63.3% (19/30) in treatment group and was 33.3% (10/30) in control group, with significant difference between the two groups (P<0.05). The KPS score of treatment group was better than that of control group (P<0.05). In treatment group, the CD3⁺ and CD4⁺ lymphocytes and the ratio of CD4⁺ to CD8⁺ lymphocytes were significantly increased after the treatment (P<0.05), and they had no significant change in control group before and after treatment. The incidences of adverse reactions, such as hematological toxicity and gastrointestinal reactions in treatment group were significantly lower than those in the control group (P<0.05). There was no significant difference in one-year survival rate between treatment group (53.3%) and control group (43.3%, P>0.05), while the two-year survival rate of treatment group was significantly higher than that in the control group (40.0% vs 13.3%, P<0.05). Conclusion Lienal polypeptide injection combined with TACE can improve the clinical efficacy and survival rate of the patients with advanced primary liver cancer.

Abstract:Objective To explore the cognition on diabetes and insulin of the patients with type 2 diabetes mellitus (T2DM). Methods We recruited 130 T2DM inpatients on insulin therapy who met our inclusion criteria. All patients finished the questionnaire surveys for related knowledge of diabetes and insulin upon admission and after receiving one-week targeted health education in hospital. Results (1) The average levels of hemoglobin A_1c (HbA_1c), fasting blood glucose (FBG) and 2-hour postprandial blood glucose (2-hPBG) were (9.82±2.37)%, (7.39±2.07) mmol/L and (10.29±3.22) mmol/L, respectively, and the standard-reaching rates were 10.00%, 53.85% and 55.38%, respectively. (2) Lack of basic knowledge of diabetes. Patients' cognition rates of target glycemic levels and frequency of glucose monitoring were low. For blood glucose control standards and monitoring frequency, the cognition rate of the patients after admission was higher than that of the patients on admission (P <0.05, P <0.01). (3) Cognitive misunderstanding on insulin. Compared to those with insulin therapy at admission, the patients who were about to receive insulin showed more anxiety about insulin usage (some P <0.05). The concerns about the use of insulin were decreased in both groups after admission (some P <0.05). (4) Awareness of disease monitoring was to be emphasized. Compared with those were to use insulin on admission, the patients with insulin therapy had better awareness of disease monitoring (P <0.05, P <0.01). The cognitive rates on disease monitoring were significantly increased in both groups after admission (some P <0.01). (5) There were great concerns about insulin therapy. They were afraid of many things including "addicted to insulin" and "fault in injecting insulin". Conclusion The blood glucose control status of T2DM patients with insulin therapy or being about to insulin therapy is poor. T2DM patients lack the related knowledge on diabetes and insulin, which is an important factor affecting insulin therapy and glucose management. Individualized T2DM education is needed to improve the situation.

Abstract:Objective To confirm the role of dipotassium ethylene diamine tetraacetate (EDTA-K₂) as the preferred anticoagulant in platelet counting using automatic hematology analyzer, and to explore the cause of pseudothrombocytopenia (PTCP) induced by EDTA-K₂ and the corrective measures for EDTA-K₂-associated PTCP (EDTA-PTCP). Methods Blood specimens were collected from 25 healthy volunteers admitted to our hospital from Jun. 2015 to Jun. 2016 and were separately anticoagulated with the anticoagulant EDTA-K₂, sodium citrate and heparin sodium; blood specimens were also collected from 10 patients with EDTA-PTCP in our hospital and were separately anticoagulated with EDTA-K₂ or EDTA-K₂+amikacin. Blood platelet in healthy volunteers and EDTA-PTCP patients was tested by automatic hematology analyzer and manual platelet counting. Results In healthy volunteers, there was no significant difference in the platelet counts between automatic hematology analyzer and the manual platelet counting with EDTA-K₂ anticoagulation for 30 min (P>0.05); and a significant difference in the platelet count was noted between automatic hematology analyzer and the manual platelet counting in the blood specimens with sodium citrate or heparin sodium anticoagulation for 5, 15, 30 and 60 min (P<0.01). The platelet count by automatic hematology analyzer was significantly lower than that by manual platelet count in the blood specimens of EDTA-PTCP patients with anticoagulation for 0, 30, 60, 90 min (P<0.01); after adding amikacin, the platelet count increased with the prolongation of time in these patients with EDTA-K₂ anticoagulation, and there was no significant difference between automatic hematology analyzer and manual platelet count at anticoagulation 90 min (P>0.05). Conclusion Anticoagulation effect of EDTA-K₂ is superior to sodium citrate and heparin sodium, and EDTA-K₂ can be used as the preferred anticoagulant in platelet detection using automatic hematology analyzer. Amikacin can correct EDTA-PTCP in the patients with anticoagulation of EDTA-K₂.

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